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authorities. She also highlighted the need to review existing core capacities and facilities in relation to those required to implement the revised IHR.
4.2 Global H ealth Security and the International H ealth Regulations
Dr Guenael Rodier, W HOHQ presented an overview of communicable disease surveillance and response. This began with an outline of the dynamic
nature of microbial threats. M icro-organisms evolve and spread resulting in the emergence and re-emergence of infectious diseases across the globe.
These natural processes are exacerbated by ‘man-made’ threats from accidental and deliberate releases of infectious agents. He outlined the three
strategic directions for responding to these threats: containing known risks; responding to the unexpected; and improving preparedness. Containing
known risks includes influenza pandemic preparedness and measures aimed at containing meningitis, yellow fever and cholera. Responding to the
unexpected includes continuous screening of events of potential international importance and outbreak responses coordinated through the Global Outbreak
Alert and Response Network GO ARN. Improving preparedness includes efficient early warning systems, integrated diseases surveillance, strengthening
national referral laboratories, strengthening bio-safety programmes, and preparedness for deliberate epidemics. The new IHR will support all of these
broad strategies.
4.3 An O verview of IH R Revision Process and Consultations
Dr M ax Hardiman, W HO HQ presented an overview of the IHR process. This began with an outline of the purpose and nature of IHR. Serious and
unusual disease events are inevitable and globalization means the effects are felt everywhere. An agreed code of conduct protects against both the risks to
public health from international spread of disease and the risk from unnecessary or excessive use of restrictions. Dr Hardiman described the legal
basis for IHR and the limitations of the 1969 version that is currently in force. He discussed the aims of the revision and the benefits that will flow from this.
He pointed out that IHR is not specifically concerned with protecting the health of travellers, or establishing surveillance for particularly diseases, though
there are synergies with these processes. He explained how IHR provides for routine measure to deal with certain known risks, and the capability to detect
and respond to sudden heightening of risk. He reminded participants that international disease control is based on early detection and control of
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emerging hazards by national systems before such events become PHEIC. W HO is committed to supporting the development of national capacity. The
Global O utbreak Alert and Response Network GO ARN provides international back-up for these capacities. Dr Hardiman described the
hierarchy of the IHR document, notably the core text, annexes, and referenced guidelines. He highlighted the key changes in the revised IHR and
the benefits that are expected from these revisions. He described the revision process and the many opportunities for input by M ember States, notably the
role of the regional consultation meeting leading up to the IGW G meeting on 1-12 November 2004. He described the key issues and concerns that have
arisen so far: scope in terms of public health emergencies and chemical and radionuclear event; possible need for disease lists; notification process; use of
unofficial information from credible sources; national sovereignty vs. international responsibilities; incentives and compliance; mandatory
timelines; role of IHR focal points; rapid response vs. transparentinclusive processes; consistency with other international obligations and treaties;
operational coordination; feasibility of implementation. He concluded by summarising the important opportunity provided by the IHR revision process.
4.4 IH R Revision Process in the W estern Pacific Region
